Pectoralis Major Tendon Rupture in an Occupational Medicine Setting: A Case Report.

Pectoralis major (PM) rupture is a rare injury, commonly misdiagnosed, that affects mostly young male athletes aged 20-40 years. This type of injury is typically associated with weight lifting, especially bench pressing. In an occupational medicine setting, it is extremely rare and not much reported in the literature. We present the case of a 30-year-old trauma technician male who presented with right shoulder and chest pain following a popping sensation while pushing in full momentum a patient on a gurney accidentally set on break mode. PM rupture was suspected clinically. Magnetic resonance imaging confirmed the diagnosis and revealed a complete rupture of the sternal head of PM. Surgical reconstruction was performed to restore the anatomy and functionality of the shoulder girdle.

The effects of standing foot-transmitted vibration on self-reported discomfort ratings.

BACKGROUND: Occupational foot-transmitted vibration (FTV) exposure is common in industries like mining, construction, and agriculture, often leading to acute and chronic injuries. Vibration assessments require technical expertise and equipment which can be costly for employers to perform. Alternatively, researchers have observed that self-reported discomfort can be used as an effective indicator of injury risk. OBJECTIVE: This study aimed to investigate the effect of standing FTV exposure on self-reported ratings of discomfort, and whether these subjective ratings differed by body area and exposure frequency. METHODS: Participants (n = 30) were randomly exposed to standing FTV at six frequencies (25, 30, 35, 40, 45, and 50 Hz) for 20-45 seconds. Following each exposure, participants rated discomfort on a scale of 0-9 in four body areas: head and neck (HN), upper body (UB), lower body (LB), and total body. RESULTS: Results indicated that participants experienced the most discomfort in the LB at higher frequencies (p <  0.001), consistent with the resonance of foot structures. The HN discomfort tended to decrease as the exposure frequency increased, although not statistically significant (p >  0.0167). The UB discomfort remained relatively low across all frequencies. CONCLUSIONS: The study suggests a potential connection between resonant frequencies and discomfort, potentially indicating injury risk. Although self-reported discomfort is insufficient for directly assessing injury risk from FTV, it provides a simple method for monitoring potential musculoskeletal risks related to vibration exposure at resonant frequencies. While professional vibration assessment remains necessary, self-reported discomfort may act as an early indicated of vibration-induced injuries, aiding in implementing mitigation strategies.

Occupational patterns of opioid-related harms comparing a cohort of formerly injured workers to the general population in Ontario, Canada.

OBJECTIVES: The role of work-related injuries as a risk factor for opioid-related harms has been hypothesized, but little data exist to support this relationship. The objective was to compare the incidence of opioid-related harms among a cohort of formerly injured workers to the general population in Ontario, Canada. METHODS: Workers' compensation claimants (1983-2019) were linked to emergency department (ED) and hospitalization records (2006-2020). Incident rates of opioid-related poisonings and mental and behavioural disorders were estimated among 1.7 million workers and in the general population. Standardized incidence ratios (SIRs) and 95% confidence intervals (CI) were calculated, adjusting for age, sex, year, and region. RESULTS: Compared to the general population, opioid-related poisonings among this group of formerly injured workers were elevated in both ED (SIR = 2.41, 95% CI = 2.37-2.45) and hospitalization records (SIR = 1.54, 95% CI = 1.50-1.59). Opioid-related mental and behavioural disorders were also elevated compared to the general population (ED visits: SIR = 1.86, 95% CI = 1.83-1.89; hospitalizations: SIR = 1.42, 95% CI = 1.38-1.47). Most occupations and industries had higher risks of harm compared to the general population, particularly construction, materials handling, processing (mineral, metal, chemical), and machining and related occupations. Teaching occupations displayed decreased risks of harm. CONCLUSION: Findings support the hypothesis that work-related injuries have a role as a preventable risk factor for opioid-related harms. Strategies aimed at primary prevention of occupational injuries and secondary prevention of work disability and long-term opioid use are warranted.

RéSUMé: OBJECTIFS: Le rôle des accidents du travail en tant que facteur de risque pour les méfaits liés aux opioïdes a été supposé, mais il existe peu de données pour étayer cette relation. L'objectif était de comparer l'incidence des méfaits liés aux opioïdes dans une cohorte de travailleurs anciennement blessés à la population générale de l'Ontario, au Canada. MéTHODES: Les dossiers de demandes d'indemnisation des travailleurs (1983‒2019) ont été reliés aux dossiers des services d'urgence et d'hospitalisation (2006‒2020). Les taux d'incidence des empoisonnements liés aux opioïdes et des troubles mentaux et comportementaux ont été estimés parmi 1,7 million de travailleurs et dans la population générale. Les ratios d'incidence standardisés (RIS) et les intervalles de confiance (IC) à 95 % ont été calculés en tenant compte de l'âge, du sexe, de l'année et de la région. RéSULTATS: Comparativement à la population générale, les empoisonnements liés aux opioïdes chez ce groupe de travailleurs anciennement blessés étaient élevés dans les dossiers des services d'urgence (RIS = 2,41, IC à 95 % = 2,37-2,45) et d'hospitalisation (RIS = 1,54, IC à 95 % = 1,50-1,59). Les troubles mentaux et comportementaux liés aux opioïdes étaient également élevés par rapport à la population générale (visites aux urgences RIS = 1,86, IC à 95 % = 1,83-1,89; hospitalisations RIS = 1,42, IC à 95 % = 1,38-1,47). La plupart des professions et des secteurs d'activité présentaient des risques de méfaits plus élevés par rapport à la population générale, en particulier la construction, la manutention, le traitement (minéral, métallique, chimique) et l'usinage des matières premières et activités connexes. Les professions de l'enseignement présentaient des risques de méfaits moindres. CONCLUSION: Les résultats confirment l'hypothèse selon laquelle les accidents du travail constituent un facteur de risque évitable pour les méfaits liés aux opioïdes. Des stratégies visant la prévention primaire des accidents du travail et la prévention secondaire de l'incapacité de travail et de la consommation d'opioïdes à long terme sont justifiées.

Electronic Health Records for Predicting Outcomes to Work-Related Musculoskeletal Disorders: A Scoping Review.

PURPOSE: Through electronic health records (EHRs), musculoskeletal (MSK) therapists such as chiropractors and physical therapists, as well as occupational medicine physicians could collect data on many variables that can be traditionally challenging to collect in managing work-related musculoskeletal disorders (WMSDs). The review's objectives were to explore the extent of research using EHRs in predicting outcomes of WMSDs by MSK therapists. METHOD: A systematic search was conducted in Medline, PubMed, CINAHL, and Embase. Grey literature was searched. 2156 unique papers were retrieved, of which 38 were included. Three themes were explored, the use of EHRs to predict outcomes to WMSDs, data sources for predicting outcomes to WMSDs, and adoption of standardised information for managing WMSDs. RESULTS: Predicting outcomes of all MSK disorders using EHRs has been researched in 6 studies, with only 3 focusing on MSK therapists and 4 addressing WMSDs. Similar to all secondary data source research, the challenges include data quality, missing data and unstructured data. There is not yet a standardised or minimum set of data that has been defined for MSK therapists to collect when managing WMSD. Further work based on existing frameworks is required to reduce the documentation burden and increase usability. CONCLUSION: The review outlines the limited research on using EHRs to predict outcomes of WMSDs. It highlights the need for EHR design to address data quality issues and develop a standardised data set in occupational healthcare that includes known factors that potentially predict outcomes to help regulators, research efforts, and practitioners make better informed clinical decisions.

The association between safety climate and noncombat injury events among United States Air Force workers.

INTRODUCTION: Work-related injuries are a common lagging safety indicator whereas safety climate assessments can help identify constructs serving as leading indicators. The National Institute for Occupational Safety and Health (NIOSH) partnered with the U.S. Department of the Air Force (DAF) Safety Center to examine the association between perceptions of safety climate survey constructs and the number of injury events within the DAF workforce. METHODS: The DAF administers voluntary, anonymous, occupation-specific safety climate surveys to DAF workers using the internal Air Force Combined Mishap Reduction System (AFCMRS). Survey responses from 2014 to 2018 provided by DAF workers and injury events in maintenance, support, and operations occupations were shared with NIOSH. Exploratory Factor Analysis revealed five constructs: Leadership and Communication; Organizational Safety Priority; Error Management; Resource Adequacy; and Deployment/Official Travel Impact. Squadron-level analysis included bivariate correlations and estimated Rate Ratios (RRs). RESULTS: 1,547 squadrons administered the survey, averaging 144 workers and 15.8 reportable injuries per squadron. Higher (more favorable) squadron-level construct scores were consistently correlated with fewer reported injuries (p < 0.001). Controlling for the number of workers, RRs revealed significant reductions in injury rates with each one-unit increase in responses: Leadership and Communication RR = 0.40 (95%CI: 0.32-0.48); Organizational Safety Priority RR = 0.50 (95%CI: 0.40-0.64); Error Management RR = 0.37 (95%CI: 0.30-0.47); Deployment/Official Travel Impact RR = 0.36 (95%CI: 0.29-0.45). Resource Adequacy revealed a non-significant lower injury rate RR = 0.87 (95%CI: 0.73-1.04). CONCLUSIONS: This unique study quantified safety climate and the association with injuries across a multi-year period. While safety climate measurements may be limited by frequent turnover and the self-reported, voluntary, anonymous nature of AFCMRS, the strength of this study is in the census of injuries. PRACTICAL APPLICATIONS: Future research should include longitudinal analyses to examine the impact on injuries when squadron leaders are provided feedback on safety climate survey results.

Descriptive summary of fatal work-related injuries, Western States, 2011-2017.

Work-related deaths are a persistent occupational health issue that can be prevented. However, prevention opportunities can be hampered by a lack of adequate public health resources. The Western States Occupational Network (WestON) is a network of federal, state, and local occupational health professionals that includes a 19-state region of the United States. To encourage public health collaboration, WestON partners examined work-related fatalities within the region. Fatality counts (numerators) were obtained from the U.S. Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries restricted-access research files for all workers ages ≥15 years and fatally injured in WestON states from 2011 through 2017. Estimates of full-time equivalent hours worked (FTE) (denominators) were retrieved from the BLS Current Population Survey. Annual average fatality rates were calculated as number of fatalities per 100,000 FTE over the study period. Rates were stratified by state, select demographics, industry sector, and event/exposure types. Pearson chi-squared tests and rate ratios with 95% confidence probability limits were used to assess rate differences. All analyses were conducted using SAS v.9.4. From 2011 through 2017, the annual average overall occupational fatality rate for the WestON region was 3.5 fatalities per 100,000 FTE, comparable to the overall U.S. fatality rate. Male workers had a fatality rate almost 10 times higher than female workers in the region. Fatality rates increased with successive age groups. Alaska and New Mexico had significantly higher fatality rates for all racial/ethnic groups compared to respective regional rates. Wyoming, North Dakota, and Montana had the three highest occupational fatality rates among foreign-born workers. Agriculture/forestry/fishing, mining/oil/gas extraction, and transportation/warehousing/utilities were industry sector groups with the three highest fatality rates regionally. Transportation-related incidents were the most frequent event type associated with occupational fatalities for all 19 states. Work-related fatalities are a crosscutting occupational public health priority. This analysis can be an impetus for collaborative multistate initiatives among a dynamic and varied occupational public health network to better meet the needs of a rapidly changing workforce.

Global Patterns of Agricultural Machine and Equipment Injuries- A Systematic Literature Review.

OBJECTIVES: Agriculture is the one of the hazardous industries in the world. Though there is significant investment in agricultural safety, machine injuries continue to be the leading cause of agriculture injuries worldwide. The objective of this study was to provide a comprehensive literature review on global patterns in agricultural machine injuries and establish a framework for future research aimed at addressing safety concerns in the agriculture sector. METHODS: The existing scholarship on farm machine injuries can be categorized into three main areas: a) farming machine/equipment injuries, b) factors associated with these injuries, and c) injury patterns. RESULTS: Overall, the findings highlight that farm tractors are the primary source of injuries for both fatal and non-fatal incidents regardless of region. Other common sources of injuries were harvesting machinery and hand/power tools in Asia, ATVs in North America and woodworking machinery in Europe. Inadequate training in operating farm equipment was reported as the most likely factor contributing to machine-related injuries. Lastly, the patterns of injuries vary based on the interaction between humans and machinery. For instance, rollovers often result in severe head and fracture injuries, while thresher incidents can lead to amputation of hands, arms, and other body parts. CONCLUSION: Addressing these injuries by implementing safety protocols will not only enhance the well-being of farm workers but potentially attract more workers to the sector, which is currently experiencing labor shortages due to machine-related injuries.

Patient handling training interventions and musculoskeletal injuries in healthcare workers: Systematic review and meta-analysis.

Workplace injuries are a serious issue for the health and social care industry, with the sector accounting for 20 % of all serious claims reported. The aim of this systematic review was to determine whether patient handling training interventions that included instruction on patient transfer techniques are effective in preventing musculoskeletal injuries in healthcare workers. Methods: Electronic databases MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and Health and Safety Science Abstracts (ProQuest) were searched for controlled trials from January 1996-August 2022. Risk of bias was evaluated using the PEDro scale and overall certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluation for each meta-analysis. Results: A total of nine studies (3903 participants) were included. There is moderate certainty evidence that could not conclude whether patient handling training affects the 12-month incidence of lower back pain (OR = 0.83, 95 % CI [0.59, 1.16]). There is low certainty evidence that patient handing training does not prevent lower back pain in health professionals without pre-existing pain (MD = -0.06, 95 % CI [-0.63, 0.52]) but may reduce lower back pain in those with pre-existing pain (MD = -2.92, 95 % CI [-5.44, -0.41]). The results also suggest that there may be a positive effect of training incorporating risk assessment on musculoskeletal injury rates; however the evidence is of very low certainty. There is low certainty evidence from a single study that training may have a short-term effect on sickness absences.) Conclusions: There is a lack of evidence to support patient handling training when delivered to all healthcare staff. Training in its current form may be an ineffective strategy for reducing musculoskeletal injuries and pain. High quality disinvestment studies or trials incorporating risk assessment strategies are warranted. Practical Applications: This review suggests health service managers question the effectiveness of current patient handling training practices and consider evaluating current practices before allocating resources to meet employee risk reduction obligations.

Occupational injuries in orthopedic and trauma surgeons in Austria.

BACKGROUND: The aim of this study was to investigate the frequency and type of injuries during the career of orthopedic and trauma surgeons in Austria. The hypothesis was that the percentage of occupational injuries among orthopedic and trauma surgeons aligns with the incidence reported in the United States, thus indicating the need for a workplace prevention program. METHODS: A web-based survey was created to collect all necessary data and was sent to all orthopedic and trauma surgeons in Austria via e-mail. Relevant parameters included the surgeons' age, work experience, severity of pain, type of injury, and current pain. Descriptive and explorative statistical analysis was performed. RESULTS: A web-based survey was sent to 1122 board-certified orthopedic surgeons and residents in Austria via e-mail. In total, the response rate was 135 (12%). Seventy-two surgeons (54%) had suffered from one or more occupational injuries during their career. We detected a significant raise of occupational injuries related to the work life duration in which operations were performed and the prevalence of injuries. Most injuries of surgeons were reported between 21 and 30 years of their professional life. According to the frequency at different locations, the distribution in descending order was 25% with injuries of the hand, 22% of finger(s), 12% of the foot, 10% of the spine, 2% of the neck, 3% of the head, and 2% of the abdomen. A causality of incapacity to work through injuries at the workplace was given as 4%. Four percent stated a sick leave of at least 3 weeks. In 7% of the facilities, there was no optimization of preventive measures following an occupational injury. We found no correlation of injuries and resident status. CONCLUSION: Orthopedic surgeons in Austria show a high incidence of occupational injuries in line with the findings of colleagues from the United States. The impact on the health system consists of absenteeism in the workplace of highly specialized health service providers as well as the incapacity to work of a high quality, highly trained workforce of at least 4%. With more preventive measures and more attention and care in the rehabilitation phase after such injuries, a positive effect could be achieved. We believe that residents should be specifically trained on how to avoid such injuries.

Electronic Health Records Role in Predicting Outcomes to Work-Related Musculoskeletal Disorders: A Study Protocol.

Work-related musculoskeletal disorders are increasing in cost and time lost from work. Electronic health records have the potential to provide rich data to help inform and predict outcomes to WMSDs. The objective is to compare an EHR dataset from an occupational health service to comparative data, to help determine if the EHR dataset can be used in future studies to predict outcomes to care.

Adverse Health Effects and Perceived Musculoskeletal Pain in the Sawmill Workers of West Bengal, India.

The present study aimed to determine the prevalence of musculoskeletal pain, unfavorable working conditions, and assessment of occupational injuries among sawmill workers. The Nordic Musculoskeletal Questionnaire, measurement of handgrip strength, working environment, and occupational injuries were assessed among 135 sawmill workers participating in the study. The data showed that sawmill workers complained of discomfort (pain) felt primarily in the low back region of the body followed by the shoulders, hands, knees, upper back, and wrist. This study indicated that sawmill workers had less handgrip strength due to more intense manual work than control subjects. Based on the results of this study, it was concluded that sawmill workers were highly affected due to working in an awkward posture with manual material handling for an extended period of time and that these factors may lead to work-related musculoskeletal disorders as well as occupational injuries. Proper training, a proper work-rest schedule, and modifications of some working procedures may reduce injuries and work-related musculoskeletal pain.

A practical framework to develop and prioritize safety interventions to improve underground coal miners' safety performance.

BACKGROUND: Improvement of workers' safety performance is an integral and essential part of safety management. Relevant safety interventions to improve workers' safety performance are generally difficult to establish when there is a wide range of occupational hazards and at-risk individuals' features. OBJECTIVE: This study aimed at formulating a practical approach to develop and prioritize potential safety interventions based on occupational and individual risk factors perceived by workers to promote workers' safety performance. METHODS: A simple framework developed to identify and prioritize the suitable safety interventions. This framework made use of data collected using standardized and validated questionnaire and domain experts' opinions. Pearson correlation coefficients, exploratory factor analysis, and multiple linear regression were used to identify significant risk factors associated with workers' safety performance. Data were collected by interviewing 202 coal mine workers with occupational injuries, and their immediate supervisors from three mines. RESULTS: Safety performance was associated with the occupational factor-domain (poor working condition, poor safety environment, poor job satisfaction, and high job stress) only (regression coefficient = 2.14, p < 0.01). The following interventions were identified and prioritized to promote workers' safety performance: provide fair compensation to workers, job-specific and safety training, promotion policy, achievable targets, relevant perks/benefits, safety training awareness, workplace lighting, ventilation network, sensitize the management, associate safety performance to promotion, and develop team spirit. CONCLUSION: Our approach helps to identify and prioritize the most relevant interventions to promote safety at work when there are multiple risk factors.

Using a severity threshold to improve occupational injury surveillance: Assessment of a severe traumatic injury-based occupational health indicator across the International Classification of Diseases lexicon transition.

BACKGROUND: Traumatic injury is a leading cause of death and disability among US workers. Severe injuries are less subject to systematic ascertainment bias related to factors such as reporting barriers, inpatient admission criteria, and workers' compensation coverage. A state-based occupational health indicator (OHI #22) was initiated in 2012 to track work-related severe traumatic injury hospitalizations. After 2015, OHI #22 was reformulated to account for the transition from the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) to ICD-10-CM. This study describes rates and trends in OHI #22, alongside corresponding metrics for all work-related hospitalizations. METHODS: Seventeen states used hospital discharge data to calculate estimates for calendar years 2012-2019. State-panel fixed-effects regression was used to model linear trends in annual work-related hospitalization rates, OHI #22 rates, and the proportion of work-related hospitalizations resulting from severe injuries. Models included calendar year and pre- to post-ICD-10-CM transition. RESULTS: Work-related hospitalization rates showed a decreasing monotonic trend, with no significant change associated with the ICD-10-CM transition. In contrast, OHI #22 rates showed a monotonic increasing trend from 2012 to 2014, then a significant 50% drop, returning to a near-monotonic increasing trend from 2016 to 2019. On average, OHI #22 accounted for 12.9% of work-related hospitalizations before the ICD-10-CM transition, versus 9.1% post-transition. CONCLUSIONS: Although hospital discharge data suggest decreasing work-related hospitalizations over time, work-related severe traumatic injury hospitalizations are apparently increasing. OHI #22 contributes meaningfully to state occupational health surveillance efforts by reducing the impact of factors that differentially obscure minor injuries; however, OHI #22 trend estimates must account for the ICD-10-CM transition-associated structural break in 2015.

Como a pandemia de COVID-19 afetou a notificação de acidentes do trabalho em diferentes atividades econômicas e ocupações no Brasil? Um estudo ecológico usando o p-score / How did the COVID-19 pandemic affect occupational accident notification in different economic activities and occupations in Brazil? An ecological study using p-score

Resumo Objetivo: mensurar o impacto da pandemia de COVID-19 nas notificações de acidentes do trabalho (AT) no Brasil, por atividade econômica e ocupação. Métodos: estudo ecológico que utilizou os casos de AT registrados entre 2015 e 2020 no Anuário Estatístico da Previdência Social. Os AT foram analisados por setor de atividade econômica, ocupação e códigos da 10ª revisão da Classificação Estatística Internacional de Doenças e Problemas Relacionados à Saúde (CID-10). Uma adaptação do p-score foi aplicada para comparar os casos de AT pré-pandemia com os do primeiro ano da pandemia. Resultados: os p-scores variaram de -60,2%, para AT por nexo técnico epidemiológico, a -13,9%, para AT típico. As doenças do trabalho apresentaram p-score de 151,1%. Houve aumento notável nos casos de doenças ocupacionais dos capítulos I e X da CID-10. As notificações de AT diminuíram em todas as categorias de atividades econômicas, exceto nas de saúde humana e serviços sociais (p-score = 8,0%). Na maioria das categorias, os valores foram negativos, exceto nos subgrupos forças de segurança e profissionais de saúde de nível superior, técnico e gestores. Conclusão: houve redução geral na notificação de AT durante a pandemia de COVID-19 no Brasil, que evidenciou desigualdades entre diferentes setores de atividades e ocupações, além de mudança no perfil de adoecimento dos trabalhadores.

Abstract Objective: to assess the COVID-19 pandemic impact on Occupational Accident (OA) notifications in Brazil by economic activity and occupation. Methods: an ecological study was conducted using OA cases recorded in the Statistical Yearbook of Social Security from 2015 to 2020. Accidents were analyzed by sector of economic activity, occupation, and ICD-10 codes. Pre-pandemic cases were compared with the first year of the public health emergency scenario caused by Sars-Cov-2 using an adapted p-score. Results: p-scores ranged from -60.2% for technical-epidemiological Occupational Accidents to -13.9% for typical OA. Occupational diseases had a p-score of 151.1%. Cases of occupational diseases from ICD-10 chapters I and X showed a significant increase. OA notifications decreased in all CNAE sections, except for human health and social services activities (p-score = 8.0%). P-score values were negative in most CBO categories, except in subgroups such as security forces and high-level health professionals, technicians, and managers. Conclusion: Brazil registered a general reduction in OA notifications due to the pandemic, which evinced inequalities in different sectors and occupations, as well as changes in the illness profile of workers.

The global prevalence of musculoskeletal disorders among firefighters: a systematic review and meta-analysis.

This systematic review and meta-analysis study aimed to explore the global prevalence of musculoskeletal disorders (MSDs) among firefighters. A systematical search was performed in three international academic databases (Scopus, PubMed and Web of Science). Overall, 31 articles were included in this review. The pooled prevalence of total MSDs in firefighters was identified as 41% (95% confidence interval [CI] [33, 50]). The prevalence of MSDs in neck, shoulders, upper back, lower back, upper extremity and lower extremity was 9% (95% CI [7, 10]), 11% (95% CI [8, 15]), 8% (95% CI [5, 12]), 31% (95% CI [27, 34]), 13% (95% CI [9, 17]) and 16% (95% CI [14, 18]), respectively. No statistically significant relationship was observed between prevalence of MSDs and year of study, mean age, size of sample, duration of prevalence, region or income level. Demographic, occupational and medical condition factors were identified that can create these disorders among firefighters.

The Relative Burden of Occupational Injuries and Illnesses in Firefighters: An Analysis of Washington Workers' Compensation Claims, 2006-2020.

Firefighters face many hazards on the job and have a high rate of work-related injuries and illnesses (WRII). We analyzed Washington workers' compensation claims from 2006-2020 to characterize WRII in firefighters compared to law enforcement officers and "all other" workers. There were 9187 compensable claims for firefighters, 7801 for law enforcement officers, and 586,939 for "all other" workers. Nearly 40% of claims for firefighters were work-related musculoskeletal disorders (WMSDs). The claim rate per 10,000 full-time equivalent (FTE) firefighters was 716.4, which is significantly higher than that of law enforcement officers (510.0) and "all other" workers (163.2). The rate per 10,000 FTE of WMSD claims was also higher in firefighters (277.0) than in law enforcement officers (76.2) and "all other" workers (57.6). Additional WRII among firefighters commonly included being struck or caught in objects, slipping or tripping, and exposure to caustic or noxious substances; and amongst law enforcement, transportation accidents and violence. Medical costs and time-loss days per claim were lower for firefighters and law enforcement than for "all other" workers. Common tasks associated with WMSDs in firefighters included lifting and transporting patients, using specific tools and equipment, and physical training. WMSDs stand out as an area for prevention and intervention activities.

The burden of occupational injury attributable to high temperatures in Australia, 2014-19: a retrospective observational study.

OBJECTIVES: To assess the population health impact of high temperatures on workplace health and safety by estimating the burden of heat-attributable occupational injury in Australia. STUDY DESIGN, SETTING: Retrospective observational study; estimation of burden of occupational injury in Australia attributable to high temperatures during 2014-19, based on Safe Work Australia (work-related traumatic injury fatalities and workers' compensation databases) and Australian Institute of Health and Welfare data (Australian Burden of Disease Study and National Hospital Morbidity databases), and a meta-analysis of climate zone-specific risk data. MAIN OUTCOME MEASURE: Burden of heat-attributable occupational injuries as disability-adjusted life years (DALYs), comprising the numbers of years of life lived with disability (YLDs) and years of life lost (YLLs), nationally, by Köppen-Geiger climate zone, and by state and territory. RESULTS: During 2014-19, an estimated 42 884 years of healthy life were lost to occupational injury, comprising 39 485 YLLs (92.1%) and 3399 YLDs (7.9%), at a rate of 0.80 DALYs per 1000 workers per year. A total of 967 occupational injury-related DALYs were attributable to heat (2.3% of occupational injury-related DALYs), comprising 890 YLLs (92%) and 77 YLDs (8%). By climate zone, the heat-attributable proportion was largest in the tropical Am (12 DALYs; 3.5%) and Aw zones (34 DALYs; 3.5%); by state and territory, the proportion was largest in New South Wales and Queensland (each 2.9%), which also included the largest numbers of heat-attributable occupational injury-related DALYs (NSW: 379 DALYs, 39% of national total; Queensland: 308 DALYs; 32%). CONCLUSION: An estimated 2.3% of the occupational injury burden in Australia is attributable to high ambient temperatures. To prevent this burden increasing with global warming, adaptive measures and industry-based policies are needed to safeguard workplace health and safety, particularly in heat-exposed industries, such as agriculture, transport, and construction.

Characteristics of fatal occupational injuries in migrant workers in South Korea: A machine learning study.

Objective: Analysis of occupational injuries is essential for developing preventive strategies. However, few studies have evaluated severe occupational injuries in migrant workers from the perspective of gender. Therefore, using a new analytical method, this study was performed to identify gender-specific characteristics associated with fatal occupational injuries among migrant workers; the interactions between these factors, were also analyzed. In addition, we compared the utility of explainable artificial intelligence (XAI) using SHapley Additive exPlanations (SHAP) with logistic regression (LR) and discuss caveats regarding its use. Materials and methods: We analyzed national statistics for occupational injuries among migrant workers (n = 67,576) in South Korea between January 1, 2007, and September 30, 2018. We applied an extreme gradient boosting model and developed SHAP and LR models for comparison. Results: We found clear gender differences in fatal occupational injuries among migrant workers, with males in the same occupation having a higher risk of death than females. These gender differences suggest the need for gender-specific occupational injury prevention interventions for migrant workers to reduce the mortality rate. Occupation was a significant predictor of death among female migrant workers only, with care jobs having the highest fatality risk. The occupational fatality risk of female workers would not have been identified without the performance of detailed job-specific analyses stratified by gender. The major advantages of SHAP identified in the present study were the automatic identification and analysis of interactions, ability to determine the relative contributions of each feature, and high overall performance. The major caveat when using SHAP is that causality cannot be established. Conclusion: Detailed job-specific analyses stratified by gender, and interventions considering the gender of migrant workers, are necessary to reduce occupational fatality rates. The XAI approach should be considered as a complementary analytical method for epidemiological studies, as it overcomes the limitations of traditional statistical analyses.

Using motor vehicle crash records for injury surveillance and research in agriculture and forestry.

PROBLEM: Fatal injuries in the agriculture, forestry, and fishing sector (AgFF) outweigh those across all sectors in the United States. Transportation-related injuries are among the top contributors to these fatal events. However, traditional occupational injury surveillance systems may not completely capture crashes involving farm vehicles and logging trucks, specifically nonfatal events. METHODS: The study aimed to develop an integrated database of AgFF-related motor-vehicle crashes for the southwest (Arkansas, Louisiana, New Mexico, Oklahoma, and Texas) and to use these data to conduct surveillance and research. Lessons learned during the pursuit of these aims were cataloged. Activities centered around the conduct of traditional statistical and geospatial analyses of structured data fields and natural language processing of free-text crash narratives. RESULTS: The structured crash data in each state include fields that allowed farm vehicles or equipment and logging trucks to be identified. The variable definitions and coding were not consistent across states but could be harmonized. All states recorded data fields pertaining to person, vehicle, and crash/environmental factors. Structured data supported the construction of crash severity models and geospatial analyses. Law enforcement provided additional details on crash causation in free-text narratives. Crash narratives contained sufficient text to support viable machine learning models for farm vehicle or equipment crashes, but not for logging truck narratives. DISCUSSION: Crash records can help to fill research and surveillance gaps in AgFF in the southwest region. This supports traffic safety's evolution to the current Safe System paradigm. There is a conceptual linkage between the Safe System and Total Worker Health approaches, providing a bridge between traffic safety and occupational health. PRACTICAL APPLICATIONS: Despite limitations, crash records can be an important component of injury surveillance for events involving AgFF vehicles. They also can be used to inform the selection and evaluation of traffic countermeasures and behavioral interventions.

Exploring factors associated with paramedic work-related psychological injury through data linkage.

INTRODUCTION: In comparison to the general population and other emergency services workers, paramedics experience high rates of work-related psychological injury. However, there is limited understanding of the case and practitioner-related factors that increase the risk of psychological injury among these workers. This paper aims to identify case and practitioner-related factors associated with paramedic work-related psychological injury in Victoria, Australia, through data linkage. METHODS: Data linkage of 7,223 paramedic injury reports with electronic patient care records, and paramedic demographic data from the single state-wide ambulance service in Victoria, Australia - Ambulance Victoria. Injuries reported between 1 January 2015 and 30 June 2020 were included. Factors associated with paramedic psychological injury were assessed using multivariable logistic regression analysis. RESULTS: A total of 4,641 (64%) injury reports were successfully linked, of which, 244 (5%) were psychological injuries. Shift hours between 0401 and 0800 (AOR 1.83; 95%CI: 1.12-2.97), cardiac arrest or deceased patient attendances (AOR 2.15; 95%CI: 1.06-4.34), hospital or medical center case locations (AOR 2.44; 95%CI: 1.22-4.91), and Priority 0 (AOR 2.27; 95%CI: 1.26-4.09), Priority 2 (AOR 1.56; 95%CI: 1.04-2.33), and Priority 3 (AOR 1.95; 95%CI: 1.15-3.32) dispatch codes were associated with increased odds of psychological injury. Increasing patient age (AOR 0.98; 95%CI: 0.97-0.99), and the absence of other emergency services on scene (AOR 0.50; 95%CI: 0.34-0.72) were associated with decreased odds of paramedic psychological injury. CONCLUSIONS: This is the first study to collectively examine and identify EMS case and practitioner-related characteristics associated with paramedic psychological injury through data linkage of EMS agency-level data sources. PRACTICAL APPLICATION: The findings of this study highlight the dispatch case characteristics that may increase the risk of a paramedic sustaining a work-related psychological injury, and consequently facilitate the early identification, intervention, and support of the individuals most at risk.